Ownership and rent-seeking behavior in specialty health care practices

Specialty health care practices are unique in that they exhibit a wide range of ownership types, from large corporations controlled by third parties to those directly owned by practitioners (physicians, therapists, etc.). Many of these practices also employ licensed assistants whose labor is partially substitutable with those of the practitioners. This paper presents a theoretical model that examines the impact that different levels of ownership have on rent-seeking behavior and efficiency within specialty practices. Our primary focus is on whether lower levels of ownership induce practitioners to extract larger economic rents by substituting their services for those of their assistants. We find that if the practitioners are not required to be technically efficient then they unambiguously respond to lower ownership with rent-seeking. However, requiring the firm to be technically (but not allocatively) efficient, may be sufficient to mitigate this incentive.efficiency

Relation of annual ring formation to rainfall as illustrated in six species of trees in Marshall county, Indiana

The relation of growth curves to rainfall is not a simple one. Such factors as the following enter to make the relation complex: the time of year when the rains come, the proportion which comes during the growing season, how well they are distributed over the growing season, the topography and its relation to run-off, the character of the soil and its ability to store water from times of abundant to tirnes of inadequate rainfall

Inferring the Latent Incidence of Inefficiency from DEA Estimates and Bayesian Priors

Data envelopment analysis (DEA) is among the most popular empirical tools for measuring cost and productive efficiency. Because DEA is a linear programming technique, establishing formal statistical properties for outcomes is difficult. We show that the incidence of inefficiency within a population of Decision Making Units (DMUs) is a latent variable, with DEA outcomes providing only noisy sample-based categorizations of inefficiency. We then use a Bayesian approach to infer an appropriate posterior distribution for the incidence of inefficient DMUs based on a random sample of DEA outcomes and a prior distribution on the incidence of inefficiency. The methodology applies to both finite and infinite populations, and to sampling DMUs with and without replacement, and accounts for the noise in the DEA characterization of inefficiency within a coherent Bayesian approach to the problem. The result is an appropriately up-scaled, noise-adjusted inference regarding the incidence of inefficiency in a population of DMUs.Data Envelopment Analysis, latent inefficiency, Bayesian inference,Beta priors, posterior incidence of inefficiency

Do Health Care Providers Quality Discriminate? Empirical Evidence from Primary Care Outpatient Clinics

There has been minimal attention paid to the mechanisms of hospital quality oversight that are currently in place. Accordingly this study will analyze the system of hospital quality regulation in the US. The Social Security Act as amended in 1965 gave the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) "deeming" power for Medicare quality requirements. There are numerous reasons why JCAHO's oversight strategy may be ineffective. The primary reason is the dual role of JCAHO as a regulator and advocate. In conclusion, JCAHO surveys do provide an incentive to hospitals to improve processes of care for the period leading up to an inspection and that incentive gets eliminated after the inspection occurs. JCAHO has announced a change from the scheduled survey to an unannounced strategy. The objective of this change is to provide an incentive to maintain a level of readiness. This may not occur if hospitals are motivated to minimize the overall cost of JCAHO compliance.

Book Reviews 63-64

Various book review

Index V.1, 1929

Information about the publication, as well as a table of contents

Nomenclatorial changes in the genus Solidago--Corrections

In making these changes several errors were made which it is here proposed to correct